Abstract

Aims and objectives: • To use Robson’s Ten Group Classification System to evaluate caesarean sections in present institution. • To understand the reasons behind the CS rates for different groups of Ten Group Classification System specific to present institution. Study Design and Settings: The prospective observational study conducted for a period of one year from 15th July 2020 to 15th July 2021 which included all women admitted in the labour room of GMERS medical college and general hospital, Gotri, Vadodara, Gujarat for delivery over in the analysis. Methods and Material: The data compilation and statistical analysis was performed according to Robson’s Ten Group Classification using Microsoft excel version 2011 and Med Calc software. For each group, we have calculated the caesarean section rate within the group and its absolute and relative contribution to the overall caes arean rate. Results: A total 1768 patients delivered in the present institute and out of which 1069 were vaginal deliveries and 699 were caesarean section over this study period of one year. The overall caesarean section rate (CSR) was 39.54%, maximum contribution to total CS was from group 5, followed by group 1, group 2, group 10, and group 3. Less contribution from group 4, group 7, group 6, group 8 and least from group 9. Group 1, 2, 3 & 4 were low risk group.

• 1.   Matangi AK, Kotipalli PL, Banavath SV, Dasi JR. Evaluation of Caesarean Section Rate Using Robson’s Ten Group Classification In A Teaching Hospital.
• 2.   Tanaka K, Mahomed K. The ten-group Robson classification: a single centre approach identifying strategies to optimise caesarean section rates. Obstetrics and gynecology international. 2017 Jan 10;2017.
• 3.   World Health Organization. Appropriate technology for birth. Lancet.1985;2:436-7.
• 4.   Boerma T, Ronsmans C, Melesse DY, Barros AJ, Barros FC, Juan L, Moller AB, Say L, Hossein poor AR, Yi M, Neto DD. Global epidemiology of use of and disparities in caesarean sections. The Lancet. 2018 Oct 13;392(10155):1341-8.
• 5.   Robson MS. Classification of caesarean sections. Fetal and maternal medicine review. 2001 Feb;12(1):23-39.
• 6.   World Health Organization. Robson classification. Implementation manual. Geneva; 2017.
• 7.   World Health Organization. WHO statement on caesarean section rates. World Health Organization; 2015.
• 8.   Torloni MR, BetranAP, Souza JP, WidmerM, Allen T, GulmezogluM, et al. Classifications for cesarean section: a systematic review. PLoSONE. 2011;6(1): e14566.
• 9.   Betran AP, Vindevoghel N, Souza JP, Gülmezoglu AM, Torloni MR. A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it. PloS one. 2014 Jun 3;9(6): e97769.
• 10.   Caughey AB, Cahill AG, Guise JM, Rouse DJ, American College of Obstetricians and Gynecologists. Safe prevention of the primary cesarean delivery. American journal of obstetrics and gynecology. 2014 Mar 1;210(3):179-93.
• 11.   NICE. Clinical Guideline 132: Caesarean Section.
• 12.   National Institute of Health and Clinical Excellence. Clinical Guideline 132: Caesarean Section.
• 13.   Dhodapkar S, Sindhu B, Daniel M, Chauhan N, Chauhan R. Analysis of caesarean sections according to Robson's ten group classification system at a tertiary care teaching hospital in South India. Int J Reproduct Contra Obstet Gynecol. 2015:745-749.
• 14.   Abubeker FA, Gashawbeza B, Gebre TM, Wondafrash M, Teklu AM, Degu D, Bekele D. Analysis of cesarean section rates using Robson ten group classification system in a ertiary teaching hospital, Addis Ababa, Ethiopia: a cross-sectional study. BMC Pregnancy and Childbirth. 2020 Dec;20(1):1-7.
• 15.   Reddy AY, Dalal A, Khursheed R. Robson ten group classification system for analysis of cesarean sections in an Indian hospital. Res J Obstet Gynecol. 2018;11:1-8.
• 16.   Sah S, Goel R, Goel JK. Analysis of caesarean section rate according to Robson’s criteria in tertiary care centre. International Journal of Reproduction Contraception Obstetrics Gynecology. 2018;7(8):3060-4.
• 17.   Costa ML, Cecatti JG, Souza JP, Milanez HM, Gulmezoglu MA. Using a Caesarean Section Classification System based on characteristics of the population as a way of monitoring obstetric practice. Reprod Health. 2010;7: 13.
• 18.   Triunfo S, Ferrazzani S, Lanzone A, Scambia G. Identification of obstetric targets for reducing cesarean section rate using the Robson Ten Group Classification in a tertiary level hospital. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015 Jun 1; 189:91-5.
• 19.   Litorp H, Kidanto HL, Nystrom L, Darj E, Essén B. Increasing caesarean section rates among lowrisk groups: a panel study classifying deliveries according to Robson at a university hospital in Tanzania. BMC pregnancy and childbirth. 2013 Dec;13(1):1-0.
• 20.   Jogia D, Lodhiya P, Kaushik. Analysis of caesarean sections according to modified Robson’s ten group classification system at a tertiary care centre in Western India. Int J Repro Contra Obstet Gynecol. 2019;8.
• 21.   Mahomed K, Pungsornruk K, Gibbons K. Induction of labour for postdates in nulliparous women with uncomplicated pregnancy-is the caesarean section rate really lower? J Obstet Gynaecol. 2016;36(7):916-20.
• 22.   Tanaka K, Mahomed K. The ten-group Robson classification: A single centre approach identifying strategies to optimise caesarean section rates. Obstet Gynecol Int. 2017;2017.
• 23.   Kansara V, Patel S, Aanand N, Muchhadia J, Kagathra B, Patel R. A recent way of evaluation of cesarean birth rate by Robson’s 10-group system. J Med Pharmaceut Allied Sci. 2014; 01:62-70.
• 24.   Royal College of Obstetricians & Gynaecologists. Birth after previous caesarean birth. Green-top guideline. 2015 Oct 31(45).
• 25.   Society of Obstetricians and Gynaecologists of Canada. Guidelines for vaginal birth after previous cesarean birth: No. 155. J Obstet Gynaecol Can. 2005;27(2):164-74.
• 26.   American College of Obstetricians and Gynecologists. Vaginal birth after previous cesarean delivery. ACOG Practice Patterns Bulletin. 1995; 1:1-8.
• 27.   Grobman WA, Lai Y, Landon MB, Spong CY, Rouse DJ, Varner MW, Caritis SN, Harper M, Wapner RJ, Sorokin Y, Network MF. The change in the VBAC rate: an epidemiologic analysis. Paediatric and perinatal epidemiology. 2011 Jan;25(1):37.
• 28.   Yeh J, Wactawski-Wende J, Shelton JA, Reschke J. Temporal trends in the rates of trial of labor in low-risk pregnancies and their impact on the rates and success of vaginal birth after cesarean delivery. American journal of obstetrics and gynecology. 2006 Jan 1;194(1):144-e1.
• 29.   Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR, et al. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Lancet. 2000;356(9239):1375-83. 20.
• 30.   Hehir MP. Trends in vaginal breech delivery. J Epidemiol Community Health. 2015;69(12):1237-9.
• 31.   Chitra TV. Analysis of caesarean delivery rates using the ten group classification system in a tertiary carehospital. Int J Reprod Contracept Obstet Gynecol. 2016;5(9):3153- 7
• 32.   Jacob KJ, Megha J, Hibina KP. TMC (Thrissur Medical College) modified Robson criteria for caesarean sections. Int J Reprod Contracept Obstet Gynecol. 2017;6(11):5038-43.
• 33.   Kant A, Mendiratta S. Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate. Int J Reprod Contracept Obstet Gynecol. 2018; 7:4674-7.
• 34.   Farine D, Shepherd D. Classification of caesarean sections in Canada: the modified Robson criteria. J Obstet Gynecol Canada. 2012;34(10):976-9.
• 35.   Prameela RC, Farha A, Bhanumathi PM, Prajwal S. Analysis of caesarean section rate in a tertiary hospital according to Robson’s ten group classification system. IOSR J Dent Med Sci. 2015;14(2):46-9.

Data Sharing Statement

Funding